Effect of smoking on early complications after elective orthopaedic surgery

Abstract

Smoking is an important risk factor for the development of postoperative pulmonary complications after major surgical procedures. We studied 811 consecutive patients who had undergone hip or knee arthroplasty, recording current smoking and drinking habits, any history of chronic disease and such intraoperative factors as the type of anaesthesia and the type and duration of surgery. We recorded any postoperative complications occurring before discharge from hospital. There were 232 smokers (28.6%) and 579 non-smokers. We found that smoking was the single most important risk factor for the development of postoperative complications, particularly those relating to wound healing, cardiopulmonary complications, and the requirement of postoperative intensive care. A delay in discharge from hospital was usual for those suffering a complication. In those patients requiring prolonged hospitalisation (>15 days) the proportion of smokers with wound complications was twice that of non-smokers.

What Factors are Associated With a Surgical Site Infection After Operative Treatment of an Elbow Fracture?

“…For closed fractures, smoking was the only factor associated with an increased risk of SSI in multivariate analysis. This is consistent with prior studies of plastic surgery of the upper extremity and orthopaedic surgery [2,6,13,20]. Smoking appears to suppress the immune system [18].…”

High body mass index is associated with increased risk of implant dislocation following primary total hip replacement: 2,106 patients followed for up to 8 years

“…Both of these risk factors have been reported to increase the risk of short-term complications such as wound infections and pulmonary events following THR (Moller et al 2003, Sadr Azodi et al 2006. Previous studies have not found any significant association between high BMI and the risk of implant dislocation in patients undergoing primary THR (Woolson and Rahimtoola 1999, Khatod et al 2006, McLaughlin and Lee 2006.…”

The incidence of complications in elective cranial neurosurgery associated with dural closure material

“…This finding is consistent with prior evidence that smoking impairs wound healing and predisposes one to infection. 20,21,28 We also found that the occurrence of CSF leak was associated with infratentorial surgery and extended treatment with corticosteroids, and that use of a synthetic dural graft decreased the likelihood of occurrence ( Table 6). These findings are consistent with a large body of experience describing CSF leak rates following infratentorial procedures of 8%-17%.…”